Breaux Bridge MM LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

BREAUX BRIDGE MM LLC

Practice address

1451 E Bridge Street
Breaux Bridge, LA 70517

Phone

(337) 456-6851

Fax

(337) 504-4798

NPI assigned

Aug 28, 2016

Organization subpart

Yes

Parent organization

1750638391As reported in NPPES

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Ashley Hill

Title

Billing Manager

Phone

(337) 781-1630

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MINUTE MED CLINIC, LLC Doing business as

Part of

Minute Med Clinic LLC

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1472342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472342400000",
    "number": "1831645191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2851 JOHNSTON ST",
            "address_2": "PMB 299",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705033243",
            "telephone_number": "337-456-6851",
            "fax_number": "337-504-4798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1451 E BRIDGE STREET",
            "city": "BREAUX BRIDGE",
            "state": "LA",
            "postal_code": "70517",
            "telephone_number": "337-456-6851",
            "fax_number": "337-504-4798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BREAUX BRIDGE MM LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "1750638391",
        "enumeration_date": "2016-08-28",
        "last_updated": "2016-08-28",
        "status": "A",
        "authorized_official_last_name": "HILL",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "337-781-1630",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1490725",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MINUTE MED CLINIC, LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sierra Boutte, LCSW
• Felicia S Bowman
• Michael Box, M.S., CCC-SLP
• Breaux Bridge Chiropractic
• Breaux Bridge Family Dentisrty
• Breaux Bridge Physical Therapy and Wellness LLC
• David Breaux, PT
• Brookshire Grocery Company
• Alan P. Broussard, MD
• Shirleen Ann Broussard, M.ED.,CCC-SLP

• Clinic/Center in Breaux Bridge, LA
• Providers in Breaux Bridge, LA by specialty
• Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.